Friday, September 30, 2011

Fracture blisters occur in about 3% of acute fractures requiring hospitalization, sometimes as early as 6 hours post fracture, with the majority appearing within 24–48 hours post fracture. Fracture blisters tend to occur in areas of tight skin without underlying muscle or adipose protection, such as the ankle, wrist, elbow, foot, and distal tibia. The blisters may be serous or hemorrhagic, with the latter representing more severe injury. Blisters usually heal by 2-3 weeks.

Some surgeons prefer to leave blisters intact and delay surgical stabilization until the blisters have resolved, pointing to evidence of increased complications (chronic ulcers, infection, and prolonged hospitalization) when surgical incisions are through blisters. However, no consensus currently exists on the optimal treatment strategy.

Familiarity with fracture blisters is required for proper assessment of pre-operative CT. They may also be occasionally seen on radiographs (image at LearningRadiology.com)